Comparison of the Clinical Results of Combined Phacoemulsification and Deep Sclerectomy with the Use of Mitomycin C at Different Sites

Abstract

To evaluate the clinical results combined phacoemulsification and deep sclerectomy (PDS) with the use of mitomicin C (MMC) at different sites. PDS with MMC was performed in patients with open angle glaucoma and cataract. The patients were divided into two groups. In 16 eyes of the first group, MMC (0.2 mg/ml) was applied to subconjunctival area and under the superficial scleral flap. In 16 eyes of the second group, MMC was applied only to the place under the superficial scleral flap. It was compared the effects of different MMC applications in between the groups. Preoperative mean intraocular pressure (IOP) was significantly decreased from 25.84±3.78 mmHg to 16.34±3.33 mmHg (p

Keywords

• Glaucoma, cataract, deep sclerectomy, phacoemulsification, mitomycine C

Comparison of the Clinical Results of Combined Phacoemulsification and Deep Sclerectomy with the Use of Mitomycin C at Different Sites

Öz

Fakoemulsifikasyon ile kombine derin sklerektomide (FDS) farklı alanlara uygulanan Mitomisin C’nin (MMC) klinik sonuçlarının değerlendirilmesi. Primer açık açılı glokom ile birlikte kataraktı olan hastalara MMC’li FDS ameliyatı yapıldı. Hastalar iki gruba ayrıldı. İlk gruptaki 16 göze, MMC (0,2 mg/ml) subkonjonktival alana ve yüzeysel skleral flebin altına uygulandı. İkinci gruptaki 16 göze ise bu uygulama sadece yüzeysel skleral flep altına yapıldı. Farklı MMC uygulamalarının iki gruptaki etkileri karşılaştırıldı. Bütün gözler ele alındığında ortalama preoperatif GİB antiglokomatöz medikasyon ile 25,84±3,78 mmHg iken postoperatif son kontrollerde ortalama GİB 16,34±3,33 mm Hg idi (p<0,001). Preoperatif dönemde en iyi düzeltilmiş görme keskinliği (EİDGK) ortalama 0,2 iken postoperatif dönemde 0,7 idi. Tam başarı oranları birinci grupta %67,3; ikinci grupta ise %54,2 idi. MMC’ye bağlı olarak görülen en sık komplikasyon avasküler bleb gelişimi idi. Birinci grupta beş gözde (% 31,25) avasküler bleb görüldü. İkinci grupta ise iki gözde (%12,5) avasküler bleb görüldü. İkinci grupta bir hastada kistik bleb görüldü. Bu iki grup karşılaştırıldığında başarı ve komplikasyon oranlarındaki farkın istatistiksel olarak anlamlı olduğu görüldü (p<0,05) . Yüzeysel skleral flep altına ek olarak subkonjonktival alana uygulanan MMC, cerrahinin başarısını arttırırken daha fazla avasküler bleb gelişimine neden olmaktadır

Anahtar Kelimeler

• Glokom, katarakt, derin sklerektomi, fakoemülsifikasyon, mitomicin C

Kaynakça

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